Chemoprevention of breast cancer for women at hgh risk

Breast cancer remains the second most common cause of cancer death in the United States. Several studies have identified cohorts of women at higher than average risk to develop this disease. These are women who are exposed to high levels of endogenous or exogenous estrogens, those with a family history of breast cancer, and those who harbor benign breast disease or genetic mutations that predispose to breast cancer. In this population group, adapting a chemoprevention strategy to decrease the risk of developing overt disease is a strong consideration. To this end, tamoxifen is the most accepted agent to date. This article will describe high risk categories that predict future development of invasive breast cancer, will summarize the current available data to support the use of tamoxifen for chemoprevention, and will further discuss adverse effects of tamoxifen as well as measures to anticipate and monitor for possible adverse outcomes

Interaction between hydrodynamics and seagrass canopy structure: Spatially explicit effects on ammonium uptake rates

The hypotheses that (1) different seagrass morphologies may facilitate different nutrient uptake rates under similar hydrodynamic forcing and (2) this effect on nutrient uptake rates is spatially explicit, with the highest uptake rates at edges of patches, where currents and turbulence are highest, were examined under unidirectional flow conditions.We thank Jos van Soelen, Bas Koutstaal, and Louie Haazen for invaluable technical assistance. In addition, we are grateful to Britta Gribsholt, Bart Veuger, Miguel Bernal, Juan Jose Vergara, and Alfredo Izquirdo for helpful discussion. In addition, we thank Josef D. Ackerman and the anonymous reviewers for comments that greatly improved the manuscript. This work and the first author were supported by an EU Marie Curie host fellowship for transfer of knowledge, MTKD-CT-2004-509254, and the Spanish national project EVAMARIA, CTM2005-00395/MAR. F.G.B. holds an EU Marie Curie individual fellowship, MEIF-CT-2005-515071. This is publication 4251 of the Netherlands Institute of Ecology (NIOO-KNAW)

Microangiopathic Hemolytic Anemia in 57-year-old Woman with Borderline Serous Tumor of the Ovary: Real-Time Management of Common Pathways of Hemostatic Failure

We present a case of a 57-year-old woman who underwent surgery for the removal of an ovarian mass but subsequently experienced microangioathic hemolytic anemia post-operatively, associated with fevers, renal insufficiency, hypertension, and hemolysis. While her clinical situations was initially suspicious for thrombotic thrombocytopenic purpura (TTP), further sorting of clinical information led to other explanations of these findings, including a systemic inflammatory response. Multiple triggers of the coagulation system which can lead to a common pathway of hemostatic failure were considered, and specific criteria seen in disseminated intravascular coagulation (DIC), TTP, heparin-induced thrombocytopenia (HIT), catastrophic antiphospholipid anitbody syndrom (APS), all of which can seem to overlap when a physician is faced with distinguishing the diagnosis clinically. We propose a chronologic and strategic approach for the clinician to consider when approaching this diagnostic dilemma

Potential uptake of dissolved organic matter by seagrasses and macroalgae

Dissolved organic nitrogen (DON) acts as a large reservoir of fixed nitrogen. Whereas DON utilization is common in the microbial community, little is known about utilization by macrophytes. We investigated the ability of the coexisting temperate marine macrophytes Zostera noltii, Cymodocea nodosa, and Caulerpa prolifera to take up nitrogen and carbon from small organic substrates of different molecular complexities (urea, glycine, L-leucine, and L-phenylalanine) and from dissolved organic matter (DOM) derived from algal and bacterial cultures (substrates with a complex composition). In addition to inorganic nitrogen, nitrogen from small organic substrates could be taken up in significant amounts by all macrophytes. Substrate uptake by the aboveground tissue differed from that of the belowground tissue. No relationships between carbon and nitrogen uptake of small organics were found. The preference for individual organic substrates was related to their structural complexity and C:N ratio. Uptake of algae-derived organic nitrogen was of similar magnitude as inorganic nitrogen, and was preferred over bacteria-derived nitrogen. These results add to the growing evidence that direct or quick indirect DON utilization may be more widespread among aquatic macrophytes than traditionally thought.This research was supported by the regional government of Andalusia project FUNDIV (P07-RNM-2516), the Spanish Project CTM2008-00012/MAR, a European Reintegration Grant (MERG-CT-2007-205675), a travel grant from Schure-Beijerinck-Popping Fund (SBP/JK/2007-32) and the Netherlands Organization for Scientific Research. Thanks to Fidel Echevarrìa Navas (Director of CACYTMAR) for granting us access to facilities, and to Bas Koutstaal for helping with sample processing. We also thank the anonymous reviewers for their valuable comments which significantly improved this manuscript

Coastal macrophytes contribute to the long term geomorphological stability of Cadiz Bay

Charla presentada en el 2015 Aquatic Sciences Meeting. Aquatic Sciences: Global And Regional Perspectives — North Meets South (http://sgmeet.com/aslo/granada2015)In the Eastern Gulf of Cadiz, terrestrial sediments are mainly supplied by the large Guadalquivir and smaller Guadalete rivers, both of which are subject to substantial man-made interventions. These rivers are the main sediment source to Cadiz Bay; a shallow, meso-tidal bay with high subtidal macrophyte coverage and extensive salt marshes that appears to act as an effective filter, retaining fine material and ensuring accretion rates that match sea-level rise. Field observations suggest that the relative importance of the different mechanisms by which macrophyte canopies promote accretion is related to their species-specific biometric properties and zonation. Overall, we argue that the key mechanism which enhances long-term accretion in the bay is related to the reduction of erosive forces on the sediment bed cause by the interaction of plant canopies with local hydrodynamics, particularly during high wind events. Considering the importance of coastal macrophytes for long-term accretion, we briefly discuss how different local and regional management strategies in relation to IPCC climate change predictions may influence terrestrial derived-sediment dynamics.EU FP7-SPACE-2013: FAST - GA n.607131, Junta Andalucia: P07-RNM-2516, P09-RNM-4853, PR11-RNM-7722,MECD: CTM2008-00012/MAR, Schure-Beijerinck-Popping Fund: SBP/JK/2007-32), E.U. MarinERA Project MedEX: CTM2008-04036-E/MAR) y PERSEUS (FP7-287600)Charla en formato pd

Foreshore Assessment using Space Technology

Poster presented in SENTINEL-2 for Science Workshop (ESA-ESRIN, Frascati, Italy) on the 20th, 21st and 22nd May 2014. See more information about this workshop in http://seom.esa.int/S2forScience2014FORESHORE ASSESSMENT USING SPACE TECHNOLOGY. Vegetated foreshores and floodplains provide important ecosystem services. These include benefits for coastal defence: the foreshores attenuate waves, enhance sedimentation and reduce erosion, mitigating flood risk. At present, this function of wetland ecosystems is hardly incorporated in coastal defence schemes. Yet considering foreshores and floodplains in water safety assessments and in levee design can result in considerable cost reductions for flood risk management. In the EU-funded project FAST (Foreshore Assessment using Space Technology, 2014-2018), we aim to develop a GMES/Copernicus downstream service, combining Sentinel satellite data and in situ data to integrate the functioning of wetlands in flood risk management strategies. Sentinel data will be used to retrieve relevant biophysical parameters to characterise the foreshore, such as the morphology/topography of the foreshores, the density/biomass and type of vegetation, and the sediment type. Because of their location at the dynamic interface of land and water, foreshores and floodplains pose particular challenges for satellite observation and analysis, both regarding spatial and spectral resolution (due to the large environmental gradients and heterogeneity) and regarding temporal resolution (due to the large temporal variation as a result of, for example, tidal inundation). Information on some key variables is not readily available, and applicability of some relevant biophysical parameters and indicators developed for the terrestrial realm (such as Leaf Area Index, NDVI) remain to be tested for the characterisation of foreshores. The advent of the superspectral Sentinel-2 MSI opens up the potential to detect such characteristics from a spaceborne platform in a consistent way, based on an appropriate spectral, spatial and temporal resolution, with substantial (regional) coverage. However, a thorough assessment is required to optimize and validate retrieval schemes for the spatial characterisation of foreshores. At eight case-study sites across Europe (Spain, Romania, United Kingdom and the Netherlands), ground referencing will be executed to aid the retrieval of information from Sentinel imagery. Validation includes measurements of sediment type and vegetation density/biomass and hyperspectral reflectance of vegetation types. The in situ and remote sensing data will be combined with measurements on wave attenuation and erosion/deposition regimes. The results will provide insight in forshore stability and in the buffering function of foreshores and floodplains. From the collected data general relationships between foreshore and floodplain characteristics and flood risk mitigation properties will be derived. These will be implemented in a GIS based tool for integrating wetlands into cost efficient and safe flood risk management strategies.This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration.POSTE

Epidemiology of drug-resistant tuberculosis among children and adolescents in South Africa, 2005-2010

OBJECTIVE : To describe the demographic and clinical characteristics of children and adolescents diagnosed with resistance to any anti-tuberculosis drug (drug-resistant tuberculosis; DR-TB) in South Africa. DESIGN : We retrospectively reviewed medical records of all children (<13 years) and adolescents (13 to <18 years) with DR-TB at specialty hospitals in four South African provinces from 2005 to 2010. RESULTS : During the review period, 774 children and adolescents (median age 11.3 years) were diagnosed with DR-TB at selected facilities. A high proportion of patients had a history of previous TB treatment (285/631; 45.2%), human immunodeficiency virus (HIV) infection (375/685; 54.7%), contact with a TB case (347/454; 76.4%), and smear-positive (443/729; 60.8%), cavitary (253/680, 38.7%) disease. Eighty-two per cent of patients with HIV infection received antiretroviral therapy. Of 626 patients diagnosed with multidrug-resistant TB (MDR-TB), 561 (89.6%) received a regimen consistent with national guidelines; the median length of treatment was 22 months (IQR 16-25). Among 400 patients with any DR-TB and a known outcome, 20.3% died during treatment. CONCLUSION : Pediatric DR-TB in these provinces is characterized by complex clinical features at diagnosis, with one in five children dying during treatment. History of previous treatment and contact with a TB patient indicate opportunities for earlier diagnosis and treatment to improve outcomes.U.S. Agency for International Development and U.S. Centers for Disease Control and Prevention, with additional support from the South Africa National Institute for Communicable Diseases and the South African Medical Research Council.http://www.ingentaconnect.comcontent/iuatld/ijtld2015-12-01hb201

Environmental Volunteering Programme for Seagrass Monitoring

Las praderas de fanerógamas marinas sufren actualmente un declive global como consecuencia de la presión humana ejercida sobre las áreas costeras y estuáricas. Frente a esta situación, la comunidad científica ha respondido creando redes de seguimiento de las praderas basadas en la participación ciudadana a través del voluntariado. Mediante la cooperación entre la Oficina Verde y el área de Ecología de la Universidad de Cádiz (UCA) se ha creado el Voluntariado Ambiental de Fanerógamas Marinas (FAMAR) en el Parque Natural Bahía de Cádiz. Este programa pretende implicar activamente a la sociedad, transmitir la necesidad de conservación de estos valiosos ecosistemas e inculcar un sentimiento de responsabilidad sobre el entorno natural en general. Tras un año de funcionamiento y con 80 voluntarios registrados, FAMAR ha cubierto con creces las expectativas de participación y han podido plantearse futuras líneas de trabajo tanto a corto como a medio y largo plazo.Seagrass meadows are currently declining worldwide, mainly as a consequence of human activities on coastal and estuarine zones. Scientists have acted against this situation by setting up seagrass monitoring networks. These networks are based on a public participation through volunteer work. Aware of this global threat on seagrasses, the Ecology research group of the University of Cadiz (UCA) together with the Green Office of this University have developed the "Environmental Volunteering Programme for Seagrass Monitoring at Cadiz Bay (FAMAR)”. The main objectives of this programme are to involve the society in seagrass conservation and to transmit a feeling of environmental responsibility. After one year of FAMAR launching, the participation level of volunteers has surpassed by far our initial expectations. FAMAR has recorded 80 volunteers, mainly UCA undergraduate students. After such a success, it has been planned new volunteering projects at the short, middle and long term.Dept. Biología, Área Ecología, Facultad de Ciencias del Mar y Ambientales, Universidad de Cádiz. Oficina Verde, Universidad de Cádiz

Use of Novel Strategies to Develop Guidelines for Management of Pyogenic Osteomyelitis in Adults: A WikiGuidelines Group Consensus Statement.

Importance Traditional approaches to practice guidelines frequently result in dissociation between strength of recommendation and quality of evidence. Objective To construct a clinical guideline for pyogenic osteomyelitis management, with a new standard of evidence to resolve the gap between strength of recommendation and quality of evidence, through the use of a novel open access approach utilizing social media tools. Evidence Review This consensus statement and systematic review study used a novel approach from the WikiGuidelines Group, an open access collaborative research project, to construct clinical guidelines for pyogenic osteomyelitis. In June 2021 and February 2022, authors recruited via social media conducted multiple PubMed literature searches, including all years and languages, regarding osteomyelitis management; criteria for article quality and inclusion were specified in the group's charter. The GRADE system for evaluating evidence was not used based on previously published concerns regarding the potential dissociation between strength of recommendation and quality of evidence. Instead, the charter required that clear recommendations be made only when reproducible, prospective, controlled studies provided hypothesis-confirming evidence. In the absence of such data, clinical reviews were drafted to discuss pros and cons of care choices. Both clear recommendations and clinical reviews were planned with the intention to be regularly updated as new data become available. Findings Sixty-three participants with diverse expertise from 8 countries developed the group's charter and its first guideline on pyogenic osteomyelitis. These participants included both nonacademic and academic physicians and pharmacists specializing in general internal medicine or hospital medicine, infectious diseases, orthopedic surgery, pharmacology, and medical microbiology. Of the 7 questions addressed in the guideline, 2 clear recommendations were offered for the use of oral antibiotic therapy and the duration of therapy. In addition, 5 clinical reviews were authored addressing diagnosis, approaches to osteomyelitis underlying a pressure ulcer, timing for the administration of empirical therapy, specific antimicrobial options (including empirical regimens, use of antimicrobials targeting resistant pathogens, the role of bone penetration, and the use of rifampin as adjunctive therapy), and the role of biomarkers and imaging to assess responses to therapy. Conclusions and Relevance The WikiGuidelines approach offers a novel methodology for clinical guideline development that precludes recommendations based on low-quality data or opinion. The primary limitation is the need for more rigorous clinical investigations, enabling additional clear recommendations for clinical questions currently unresolved by high-quality data

Hispanic Latin America, Spain and the Spanish-speaking Caribbean: A rich source of reference material for public health, epidemiology and tropical medicine

There is a multiplicity of journals originating in Spain and the Spanish-speaking countries of Latin America and the Caribbean (SSLAC) in the health sciences of relevance to the fields of epidemiology and public health. While the subject matter of epidemiology in Spain shares many features with its neighbours in Western Europe, many aspects of epidemiology in Latin America are particular to that region. There are also distinctive theoretical and philosophical approaches to the study of epidemiology and public health arising from traditions such as the Latin American social medicine movement, of which there may be limited awareness. A number of online bibliographic databases are available which focus primarily on health sciences literature arising in Spain and Latin America, the most prominent being Literatura Latinoamericana en Ciencias de la Salud (LILACS) and LATINDEX. Some such as LILACS also extensively index grey literature. As well as in Spanish, interfaces are provided in English and Portuguese. Abstracts of articles may also be provided in English with an increasing number of journals beginning to publish entire articles written in English. Free full text articles are becoming accessible, one of the most comprehensive sources being the Scientific Electronic Library Online (SciELO). There is thus an extensive range of literature originating in Spain and SSLAC freely identifiable and often accessible online, and with the potential to provide useful inputs to the study of epidemiology and public health provided that any reluctance to explore these resources can be overcome. In this article we provide an introduction to such resources